I have Crohn's Disease and for the past year I've been eating a ZC/VLC diet in an attempt to maintain remission without medications. I just had my yearly colonoscopy on Friday, and I passed with flying colors - no Crohn's activity, 9 months without medication, one year on the diet, which is intended to be zero starch to prevent a specific bacterial activity in the colon.
Anyway, with that result I've started to wonder what to do next. Eating meat, cheese and eggs isn't all that bad, but being ketogenic all the time probably isn't optimal when it comes to recovery from exercise, and I'd like to start training harder than I currently do (strength). I've come up against a bit of a dilemma:
Where do I get carbs without starch? The common paleo answers are out (no starchy tubers for me) and I'm having a hard time finding information on the starch content of vegetables. Most foods aren't chock full of freely available glucose. I've been looking at the SCD Diet legal/illegal list and it seems full of contradictions or oddities like disallowing sugar but allowing ripe bananas... as if they ever get fully fermented?
So if you were shooting for (say) 50g of carb a day, and your only restriction was NO complex sugars (di- or poly- saccharides, ie starches), how would you do it?
For 50 grams a day you can get the low GI carbs -- berries (if you don't have any diverticulitis where the tiny seeds get stuck), purple sweet potatoes (I don't believe these are nightshades; the Japanese and okinawan varieties have more antioxidants), green apples, vegetables that you are not allergic too (or better juice them like celery, kale, watercress, cilantro, carrots, etc)...
Have you considered the high value of vitamin D for GI dysbiosis? Neonomide (friend and commenter at HERE) has had quite a lot of success with vitamine D, beta-alanine and carnosine for recovery and maintenance of remission of his Crohn's.
Get your 25OHD vitamin D blood level to 70 ng/ml. This is the level which maintains me asthma-free (and my kids) -- we're all off our our inhalers. vitamin D has HEEEYGE immuno modulation benefits for all organs, particularly the GI tract.
Maintain good trace minerals and magnesium. Mag malate is a good easily absorbed source which does not induce loose stools (oxide is the worst; avoid). Bone broths/marrow-soups are great for collagen and calcium and minerals!
Glutamine? Very specific amino acid the enterocytes. Regrows the shortened damaged villi.
Omega-3 and vitamin A? Taurine? All found in fish/sardines/anchovies of course -- all very helpful also in rebuiding the GI tract.
Ayers talks about avoiding feeding the Klebsiella -- probiotics are important to balance and prevent overgrowth of the bad gut bacterial like Klebsiella and the prebiotics (food) to feed the good bacteria are vital as well. I added some veggies and green apples but I actually have found the easiest to feed them with metamucil/konsyl 1-2 tsp a couple of times per week when I don't eat veggies (too lazy). If you take probiotics, don't forget to cycle them which mimics random evo/paleo eating...
Sounds like you have made amazing progress! Would love to hear later what works the best for you...
Perhaps coconut water would be an option, like this one: http://www.vitacost.com/Vitacoco-100-Pure-Coconut-Water-11-1-fl-oz Fifteen grams of carb, no fiber. Apparently, a lot of people are liking it as a sports drink because of the electrolyte balance, plus it's relatively natural. I'd just check into the processing options is all.
I have AS, which is a klebsiella-powered autoimmune condition like Crohn's. I've followed Ebringer's zero-starch protocol (as described in Carol Sinclair's book) and understand there are a lot of veggie options that provide carbs with only trace amounts of starch. I know your goal is zero, but rather than jump into yams and sweet potatoes from dairy and meat, you may want to try adding in veggies with virtually no starch and see how you do. Kleb will always be in your system, it's about controlling the population, and my understanding is that these very small amounts of starch are OK and will not lead to overgrowth.
For the starch content of vegetables, try this:
Do you test your food with iodine? I'm sometimes very surprised at what has starch when I do.
Hmmmm...I may be way out in left field, but had pretty severe ulcerative colitis which resoved through VLC/LC/"clean" eating over a couple of years. It was severe enough that after I was clear for 3 years I had an anal repair surgery to fix a large/healed fissure and some prolapse. No symptoms since late 02 and repair done in 05 and no problems since.
I do fine with what are considered to be non-low starchy carb veggies - all kinds of salad herbs and lettuces, tomatoes, all kinds of bell peppers, broccoli, kale, all kinds of greens like mustards, onions,cauliflower, little yellow "summer squash," okra, eggplant,green beans, wax beans, mushrooms, brussels sprouts cabbage,zucchini.
Some people have problems with the cruciferous veggies re: gas/bloating. I do not. Or it is minimal and non-problem producing. I saute okra, yellow squash and cabbage and quick sort of stir fry them and do very well with them that way - also brussels sprouts and kale. Anyhow, some people have problems with those and broccoli and cauliflower. I can eat them cooked or raw (broccoli, cauli cabbage) now with little problem. And I eat LOTS of them.
Having "been there" with a like disorder, I am very happy for you. I'd say take it slowly. And experiment with cooking carefully.
And if I am out in left field, then I apoloigze and hope you find the info you need!
My thought regarding ZC v LC diets for IBD related disease, are that in the initial stages of recovery (if you are in an acute, 10-20 bowel movements/day scenario) a ZC approach may be needed to kick start remission.
However for most people (who are not on a viscious downward malabsorption spiral) a LC approach will most likely be sufficient to head into remission. As we know, KP bacteria are comensal. We will never get rid of them completely. People with the HLA-B27 marker, or IBD just need to starve them enough to re-adress the balance within the colon. The immune system like balance.
In my journey to better health, I learnt the hard way that I couldn't get well, and I mean sustainably better, not a "quick fix" better, unless I took a balanced approach to my eating habits. I can understand the desire to be ZC, because mentally it is nice to think we will "exterminate" the badbugs. However, reality is different. The human gut, mind and body can only maintain long term health through balance. Any extreme approach (though maybe necessary in some for a month or two) in the long run will fail. I carry this approach to all areas of life, health and politics too!
Good luck to you all !
Wow, that's a tough one. If complex sugars are out then fructose and glucose are the only options right? If I am not mistaken all fruits and veggies contain complex carbohydrates, even cellulose is a polysaccharide. That leaves you with honey and sugar. Probably not what you want to eat every day! Liver has about 7-12 grams of carbs, store bought kombucha has 14 grams in 16 oz and 1+1/2 Tbs raw honey has 25 grams. That gives you about 50. Not sure eating liver every day is a good idea though. Of course most might say eating honey every day isn't a great idea either! Might be your best option though...
You might try doing a Targeted Ketogenic Diet (TKD), which means you stay ZC/VLC all the time except you ingest 10-50 grams or so of dextrose right before lifting. I did this for a while, and it improved my performance at that time. A roll of Smarties (the American kind, not the Canadian, which are chocolate) is 5g of pure dextrose.
ETA: There is also coconut oil, which some people say acts somewhat like carbohydrate in giving a burst of energy for athletics. I haven't tried it myself.
Maybe I'm not understanding but if you have been successfully ZC and are feeling great why would you want to change that? If it's an energy thing I'd agree with a previous poster and try coconut oil, you may not be getting enough fat. There is nothing magical about carbs, you don't need them. I have been doing heavy strength training for over a year while ZC, plenty of fat tho, and have endless energy. I fast a lot too. A spoon of coconut oil or a gulp of cream is a wonderful energy boost too. There is nothing wrong with being "ketogenic all the time" so if that is your only concern I wouldn't worry about it..
Doesn't the SCD allow things like honey and fruit juice? Simple sugars usually get absorbed in the small intestine and don't make it to fermentation. So any non-starchy fruit would be up for grabs.
I found that once I was on LC long enough I was able to add back in starch without a problem though, but I had IBS not Crohns.
I would rebuild my gut bacteria so I could tolerate some of the starchy vegetables.
Ayers has a couple posts that implicate highly dysfunctional gut bacteria in Crohn's.
"The bacterial gene compostion of individuals diagnosed with Crohn’s Disease and ulcerative colitis were different and distinct from healthy individuals. Individuals with Crohn’s disease had 25% fewer species of gut flora than comparable healthy controls." http://coolinginflammation.blogspot.com/2010/03/human-gut-flora-genes.html
Have you read/tried Ayers suggests on pectin/inulin rich foods (apples/tomatos & leeks/onions)?
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